Translational research for recurrent lung cancer treatment with combination therapy of gefitinib and meloxicam

已有研究表明，EGFR抑制剂吉非替尼对复发性非小细胞肺癌(NSCLC)治疗有效。COX-II的过度表达与非小细胞肺癌的预后密切相关。抗癌药物与COX-II抑制剂之间存在一定的协同作用。COX-II的表达与EGFR有关。基于这些结果，我们进行了NSCLC的II期临床试验，以观察吉非替尼和COX-II抑制剂美洛昔康联合治疗的疗效。[目的]本研究的目的是评价吉非替尼和美洛昔姆联合治疗的有效率和安全性。[患者]NSCLC患者经组织学诊断，疗效良好(0-2)，在两种治疗方案内，且有可测量的病变。[方法]所有患者均接受吉非替尼250 mg/美洛昔康10 mg/d治疗，第1天至PD。[结果]23例患者纳入本研究。这些患者的背景如下：男性/女性：10/13、组织学；腺癌/鳞癌/非小细胞肺癌：18/3/2、PS(功能状态)0/1/2：3/18/2，临床分期；III/IV：5/18、MST：210天。我们未发现EGFR的表达水平有任何相关性。组织病理学染色中磷酸化相关的EGFR、COX-II的表达。COX-2、PEG2、PGI2等前列腺素水平与COX-2、PEG2、PGI2水平无关。

It has been said that inhibitor of EGFR, gefitinib is effective for reurrent pretreated Non Small Cell Lung Cancer (NSCLC). Overexpression of COX-II is highly related to prognosis for NSCLC. There are some synergism in anticancer agents and COX-II inhibitors. Expression of COX-II is related to EGFR. Based on these results we conducted phase II clinical trial for NSCLC to investigate effectiveness of combination therapy with gefitinib and COX-II inhibitor, meloxicum.【Objectives】 The objective of this study is to evaluate the response rate and safety of combination therapy with gefitinib and meloxicum.【Patients】 NSCLC patients diagnosed with histology, good performance status(0-2), within 2 regimens of prior treatment and having measurable lesions were eligible for this study.【Methods】 All patients were treated with gefitinib 250mg/meloxicum 10 mg once a day from day 1 until PD.【Results】 Twenty three patients were enrolled. Backgrounds for these patients were as follows; male/female: 10/13、histology; adenocarcinoma/squamous cell carcinoma/NSCLC: 18/3/2、PS (performance status) 0/1/2:3/18/2, clinical stage; III/IV:5/18、MST: 210days. We did not see any correlation in expression level of EGFR. Phosphorelated EGFR, expression of COX-II in histopathopogical staining. There were no relation in plasma level of COX-2, PEG2, PGI2 and other prostagrandines.